Person–Environment Fit and Functioning Among Older Adults in a Long-Term Care Setting

Person–environment fit (P-E Fit) is measured by considering the person, defined as a set of competencies, and the environment, defined in terms of demands. P-E Fit occurs when there is a match between the personal and environmental component. The purpose of this study was to describe and compare P-E Fit among residents living in “Welcome Home” (WH) versus those in traditional nursing home (TNH) environments and to determine whether there was a relationship among P-E Fit, physical activity, and functional performance and whether fit tends to be the same or different across these settings. A quasi-experimental, repeated-measures design was used that included 29 residents with 16 (55%) from WH and 13 (45%) from TNH. The residents were mostly female (n = 21; 78%) and were all white (100%) with a mean age of 87.4 (SD = 6.7). The Housing Enabler instrument was used to Measure P-E Fit. Accelerometry (ActiGraph), the Physical Activity Scale for Long Term Care (PAS-LTC), and the Barthel Index were used to evaluate physical activity and function. Overall a better P-E Fit was associated with more physical activity and more independent function. There were no significant differences in P-E Fit between WH and TNH sites with the exception of the indoor P-E Fit subscale where the WH group had significantly more barriers to function and physical activity (p = .03). ActiGraph total activity counts were indicative of a sedentary lifestyle of all participants (729 steps/day). Surprisingly, the TNH group had significantly more physical activity based on mean activity counts (p = .003) and steps (p = .02). No differences between the groups with regard to function on the Barthel Index (p = .30) or subjective physical activity using the PAS-LTC (p = .95) was found. Ongoing use of the Housing Enabler to evaluate the fit between the environment and the person is recommended, as is using these findings to implement interventions to facilitate function and encourage residents to engage in physical activity.